The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

Abstract

ObjectiveTo prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days.Methods15 healthy male volunteers (mean 35.9 years, range 27–53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner.ResultsAll subjects completed the four MRIs. Mean prostate volume was 22.45 cm3 (range 13.04–31.21 cm3), with no change between the four studies (p = 0.89–0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm3 (−25.6%, p < 0.001), and a significant reduction from baseline to day 2 (−18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10−3 mm2/s at day 1 (mean −4.3%, p = 0.009).ConclusionThe longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI.Key Points• Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2 • Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation • There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation • 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-017-4905-x) contains supplementary material, which is available to authorized users.

Relationship of Seminal Megavesicles, Prostate Median Cysts, and Genotype in Autosomal Dominant Polycystic Kidney Disease

“…Chronic kidney disease in ADPKD subjects might account for some of these findings, (eg, free pelvic fluid), although there was no significant correlation between eGFR and free pelvic fluid. Changes in SV lumen diameter occurring with time since last ejaculation were not accounted for, although it is unlikely that this could change normal SV to megavesicle or vice versa. Slice thickness on the T 2 ‐weighted images was 8 mm, which limits the ability to accurately measure the lumen diameter of small SVs.…”

mpMRI of the Prostate (MR-Prostatography): Updated Recommendations of the DRG and BDR on Patient Preparation and Scanning Protocol

“…Studies have examined the behavior of T2w imaging in healthy subjects and found a T2w signal decrease in the peripheral zone after ejaculation [28,29]. Another study in healthy subjects concluded that the ADC value in diffusion-weighted imaging post ejaculation is also reduced [30]. This effect was evident for over 24 hours; parameters normalized afterward.…”

Multiparametric MRI - local staging of prostate cancer and beyond

“…Although PI-RADS v2 does not recommend abstinence from ejaculation prior to prostate mpM-RI19, some centres require patients to refrain from ejaculation prior to imaging in order to achieve maximal distension. Recent studies suggest 72 hours abstinence as the recommended interval to achieve maximal seminal vesicle distension 66, 67, 68, 69,. This may be beneficial in evaluation of seminal vesicle invasion but further prospective studies including patients with prostate cancer are required to determine the effect on local staging accuracy.…”